title: Incidence of tracheobronchial anomalies found with hypoplastic left heart syndrome.
abstract: BACKGROUND
  Tracheobronchial anomalies are rare congenital malformations that are typically managed conservatively. Several reports have documented their increased incidence in patients with congenital heart disease. However, none of these reports have detailed the incidence found among patients with hypoplastic left heart syndrome (HLHS). Airway obstruction, whether by extrinsic compression or an undiagnosed tracheobronchial anomaly, in the perioperative period may have significant morbidity in this tenuous population.
  
  
  METHODS
  From June 2003 to August 2011, 164 consecutive patients with HLHS underwent a palliative surgical procedure for their cardiac disease. Sixty-three of these patients received either multidetector computed tomography (CT) of the chest or cardiac magnetic resonance imaging (MRI). A total of 124 studies (106 CT, 18 MRI) were performed during this time span. The studies were reviewed independently by a pediatric cardiologist and a pediatric radiologist. Length of intubation, intensive care unit (ICU) stay, and hospital stay were also reviewed for all patients.
  
  
  RESULTS
  Three of the 63 patients had a congenital abnormality of the tracheobronchial tree (4.8%), which is higher than the incidence that has been reported in the general population. Two of the patients had bilateral left-sided bronchus with an absence of the right upper lobe bronchus. The third patient was found to have a very rudimentary right upper lobe bronchus with absence of the right upper lobe of the lung. The mean intubation time was not significantly different between the groups (P = .615). There was no significant difference of either the total ICU or hospital stay between the two groups.
  
  
  CONCLUSIONS
  Our study demonstrates a higher incidence of tracheobronchial anomalies among patients with HLHS, a severe form of cyanotic congenital heart disease. Patients with a tracheobronchial abnormality did not show a difference in morbidity during the postoperative time period.
authors.affiliation: Division of Cardiology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA.
authors.forename: Cory V
authors.initials: CV
authors.lastname: Noel
authors.forename: John P
authors.initials: JP
authors.lastname: Kovalchin
authors.forename: Brent
authors.initials: B
authors.lastname: Adler
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Yates
mesh_terms: D001980:Bronchi / Q000002:abnormalities*; D006348:Cardiac Surgical Procedures; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D015994:Incidence; D007362:Intensive Care Units; D007442:Intubation, Intratracheal; D007902:Length of Stay; D008279:Magnetic Resonance Imaging; D061330:Multidetector Computed Tomography; D009820:Ohio / Q000453:epidemiology; D010166:Palliative Care; D015619:Respiratory System Abnormalities / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014132:Trachea / Q000002:abnormalities* / Q000000981:diagnostic imaging; D016896:Treatment Outcome
keywords: Airway Malformations; Hypoplastic Left Heart Syndrome; Tracheobronchial Anomalies